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Feel like there is a stone under your foot?
Could be Plantar Fasciitis

By Ocean Kwok

Foot pain, corns and calluses, dry skin on legs, man suffering from feet ache at home, pod

Plantar fasciitis is one of the most common causes of heel pain. It can affect people of all ages, although it is more common in middle-aged adults. People who spend a lot of time walking or standing, or who participate in activities such as running and dancing, may have a higher risk of developing plantar fasciitis.

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The plantar fascia is a strong band of connective tissue that runs along the bottom of the foot. It helps support the arch of the foot and assists with absorbing and transferring forces when we walk and run.

Plantar fasciitis usually causes pain around the bottom or inside of the heel, particularly where the plantar fascia attaches to the heel bone (calcaneus).

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What does plantar fasciitis feel like?

One of the most common symptoms is “first-step” pain — pain or stiffness when taking the first few steps after getting out of bed in the morning or after sitting or resting for a period of time. It can feel like there is a stone under your foot.

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The pain may improve as you move around, but can return or increase with prolonged walking, standing, running or other weight-bearing activities.

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Symptoms can vary between individuals. Some people experience mainly heel pain, while others may also experience discomfort along the arch of the foot.

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What causes plantar fasciitis?

Plantar fasciitis is usually related to a combination of factors rather than one single cause. These may include:

  • A sudden increase in walking, running or other physical activity

  • Prolonged standing or walking

  • Reduced calf or ankle mobility

  • Reduced strength or capacity of the calf and foot muscles

  • Changes in training load

  • Body weight

  • Foot structure and biomechanics, including very high or low arches

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Importantly, having flat feet or high arches does not automatically mean that someone will develop plantar fasciitis. It is often the combination of foot structure, muscle capacity and the amount of load placed on the foot that contributes to symptoms.

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How can physiotherapy help?

Treatment aims to reduce pain while gradually improving the ability of the foot and calf muscles to tolerate everyday and sporting activities.

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Physiotherapy may include:

  • Activity modification: Temporarily reducing or modifying activities that significantly aggravate symptoms while maintaining appropriate movement.

  • Education: Understanding your symptoms, activity levels and factors that may be contributing to your pain.

  • Taping: Foot or plantar fascia taping may provide short-term pain relief and help some people tolerate walking and exercise.

  • Manual therapy: Massage or other hands-on techniques may be used to temporarily reduce pain and improve mobility.

  • Progressive strengthening: Exercises such as calf raises and other foot and lower-limb strengthening exercises can progressively increase the capacity of the muscles and plantar fascia to tolerate load.

  • Stretching: Calf and ankle mobility exercises may be useful for some people, particularly when mobility is restricted.

  • Orthotics: In some cases, temporary or longer-term foot orthoses may help reduce symptoms and improve comfort during weight-bearing activities. They are generally used as part of a broader treatment program rather than as a standalone treatment.

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The importance of gradual loading

Although reducing aggravating activities can be helpful initially, complete rest is usually not the long-term solution. The plantar fascia and surrounding muscles need to gradually adapt to the loads placed on them.

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Your physiotherapist can help determine an appropriate level of activity and develop a progressive exercise program based on your symptoms, goals and daily activities.

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When should you see a physiotherapist?

If you have persistent heel or foot pain, particularly if it is affecting your walking, exercise, work or daily activities, a physiotherapist can assess your symptoms and determine whether plantar fasciitis is the likely cause.

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A physiotherapist can also assess other possible causes of heel pain, provide appropriate treatment and help you gradually return to the activities you enjoy.

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If your heel pain is severe, worsening, associated with significant swelling or trauma, or is not improving, seek assessment from an appropriate healthcare professional.

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If you would like to make an appointment, click here to make an online booking, or call (07) 3211 8775 to speak with our friendly reception staff. 

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